Colon Cancer

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Cancer of the large bowel, or colon and rectum, is often referred to as colorectal cancer. It is the second most commonly diagnosed malignancy in the United States and is the second highest cause of cancer death.

Colorectal cancer affects the lower intestinal portions of the digestive system, the colon and rectum. Together, they form a long, muscular tube called the large intestine (also called the large bowel). The colon is the upper 5 to 6 feet of the large intestine, and the rectum is the last 6 to 8 inches.

Tumors can develop anywhere in the colon or rectum. If colorectal cancer cells spread outside the colon or rectum, they often travel to nearby lymph nodes (sometimes called lymph glands). Colorectal cancer can also spread to other parts of the body, especially the liver, and sometimes to the lungs, bones and other organs.

Variables governing prognosis include the degree of penetration of the tumor into the bowel wall and the degree to which lymph nodes around the bowel are affected. Age is also a factor: If patients age 70 or older are diagnosed with colon cancer, the prognosis usually worsens.

The risk of developing colorectal cancer is strongly connected to one's family history: When compared to the general population, people who have a family history of colorectal cancer face approximately twice the risk of developing the disease. Families that are at high risk because of multiple affected family members can be at a 10-fold greater risk than the general population. Also, if cancer develops in high-risk individuals, it frequently occurs between the ages of 40 and 50, rather than later in life.

Having had ulcerative colitis, or breast, ovarian or endometrial cancer may put one at greater risk for colorectal cancer. People who enjoy eating meat that is burnt or charred are at greater risk as well.

Primary symptoms include a change in bowel habits; diarrhea or constipation; blood in or on the stool (either bright red or very dark in color); stools that are narrower than usual; general stomach discomfort (bloating, fullness and/or cramps); frequent gas pains; feeling that the bowel does not empty completely; weight loss for no known reason; and constant fatigue.

Colorectal cancer is highly treatable, even curable, by surgery in about 50 percent of cases, especially those that have been detected early. Surgery is often followed by "adjuvant" (auxiliary) therapy such as chemotherapy. Many clinical trials of experimental therapies are available for those whose cancer recurs or if the cancer is at an advanced stage when first detected.

Research suggests that lifestyle modication with regard to patterns of diet, exercise, and tobacco use, among other factors, is the best way to prevent any form of cancer, including colon cancer.

Since the chance of being cured dramatically increases if the cancer is detected before it has spread, much emphasis is placed on screening and early detection. The American Cancer Society recommends that for the average-risk population, people over 50 be tested annually for blood in the stool and have flexible sigmoidoscopy every five years. For those at higher risk, colonoscopy or other procedures may be recommended.

Genetic testing isn't widely available yet, but may be valuable for some people at high risk.